Ayob, Muhammad Aslam
(2018)
The effectiveness of modified heart score in evaluating patient presented with chest pain to Emergency Hospital Universiti Sains Malaysia.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction: Chest pain is one of the most common reasons for patients visit to
emergency department. The aim of diagnostic process in chest pain at emergency
department is to identify both low risk and high risk patients for acute coronary syndrome.
Our study objective is to evaluate the effectiveness of modified HEART score in patients
presented with chest pain.
Methods: Total of 175 patients presented with chest pain at Emergency Department
Hospital Universiti Sains Malaysia (EDHUSM) were evaluated retrospectively. The
modified HEART score was calculated using patient’s history, ECG, age, risk factor and
CKMB/CK relative index. The endpoint was occurrence of major cardiac event (MACE)
in 6 weeks’ time. The efficiency of modified HEART score was compared between low
risk and non-low risk group.
Result: Out of 175 patients evaluated, 30.9 percent of the patients was low risk (score 0-3)
category of modified HEART score. However, 14.8% patients from low risk group
developed MACE in 6 weeks’ time. The mean of modified HEART score for MACE in 6
weeks was 6.01 for non-low risk and 4.05 for low risk group and statically significant (p
value <0.001). There was also significant association between non-low risk group of
modified HEART score and the occurrence of MACE (x2=22.35, p<0.0.001).
Conclusion: The modified HEART score can assist clinician with quick and reliable
predictor outcome without complicated calculation technique. It is a useful alternative to
original HEART score for the center without troponin test. The MHS was reliable to
identify patients with non-low risk (score 4-10). On the other hand, the MHS cannot be
dependable to risk stratified low risk patient and further testing needed for this group of
patient.
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